title: Influence of additional criteria from a definition of cachexia on its prevalence--good or bad thing?
abstract: OBJECTIVE
  Cachexia is a state of involuntary weight loss. The latest generic definition states that aside from weight loss, patient needs to fulfill additional criteria to be diagnosed with cachexia. New, condition-specific definitions also take the weight loss as a principal criterion, and additional criteria are not mandatory but are a part of further assessment. The aim of this study was to reveal the influence of additional criteria on the prevalence of cachexia in patients with various diseases linked to cachexia. Owing to this, we used the last generic definition. Possible differences in clinical presentations of patients with documented weight loss, with the respect of fulfillment of additional criteria were sought.
  
  
  METHODS
  Clinical and anthropometric data on 137 consecutive patients with malignant diseases and chronic heart failure from a single institution were collected.
  
  
  RESULTS
  Fourty-two (30.6%) patients had >5% weight loss in the last 12 months. Only 30 (21.8%) of them were found to meet additional three out of five criteria proposed by the new definition. This observed difference in the prevalence of cachexia diagnosed with or without using additional criteria was found to be significant (P=0.0006). Comparison of clinical/laboratory data showed significantly higher levels of C-reactive protein and lower levels of albumin, as well as lower measurements of mid-arm circumference, triceps and suprailiac skinfolds in patients that fulfilled additional criteria. Survival analysis did not show reduced survival of patients fulfilling additional criteria.
  
  
  CONCLUSIONS
  Additional criteria 'reduce' the prevalence of cachexia. They are indicative of differences in laboratory and clinical features of cachectic patients but do not influence their survival.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, University Hospital Merkur, University of Zagreb School of Medicine, Zagreb, Croatia. letilovic@yahoo.com
authors.forename: T
authors.initials: T
authors.lastname: Letilovic
authors.forename: R
authors.initials: R
authors.lastname: Vrhovac
mesh_terms: D001823:Body Composition; D002097:C-Reactive Protein / Q000378:metabolism*; D002100:Cachexia / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism*; D009369:Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D015995:Prevalence; D011378:Prognathism; D012709:Serum Albumin / Q000378:metabolism*; D012885:Skinfold Thickness; D016019:Survival Analysis
chemical_list: D012709:Serum Albumin; D002097:C-Reactive Protein